Lortab

NURS 2516 Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name Hydrocodone/acetaminophen

Trade Name Lortab

Classification opioid agonists/nonopioid analgesic combinations

Peak

Onset

Duration

30-60 min

10-30 min

4-6 hr

Dose

Route

Time/frequency

5/550 1-2 tab

po

Q 4˚ PRN

Mechanism of action and indications (Why med ordered)

Normal dose range

2.5-10 mg q 3-6 hr as needed; if using combination products, acetaminophen or aspirin dosage should not exceed 4 g/day

Nursing Implications (what to focus on) Contraindications/warnings/interactions

Bind to opiate receptors in the CNS. Alter the perception of and response to painful stimuli while producing generalized CNS depression Moderate pain

Hypersensitivity, hypothyroidism

Common side effects confusion, sedation, hypotension, constipation

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically) nalbuphine

Lab value alterations caused by medicine

May cause increased plasma amylase and lipase concentrations

Be sure to teach the patient the following about this medication

Advise patient to take medication exactly as directed and not to take more than the recommended amount. Severe and permanent liver damage may result from prolonged use or high doses of acetaminophen. Renal damage may occur with prolonged use of acetaminophen or aspirin. Doses of nonopioid agents should not exceed the maximum recommended daily dose Instruct patient on how and when to ask for pain medication May cause drowsiness or dizziness. Advise patient to call for assistance when ambulating Advise patient to change positions slowly to minimize orthostatic hypotension Encourage patient to turn, cough, and breathe deeply every 2 hr to prevent atelectasis Advise patient that good oral hygiene, frequent mouth rinses, and sugarless gum or candy may decrease dry mouth Nursing Process- Assessment (Pre-administration assessment) Assess blood pressure, pulse, and respirations before and periodically during administration. Assess type, location, and intensity of pain prior to and 1 hr (peak) following administration. Assess bowel function routinely. Prevention of constipation should be instituted with increased intake of fluids and bulk, and laxatives to minimize constipating effects. Stimulant laxatives should be administered routinely if opioid use exceeds 2-3 days, unless contraindicated

Assessment

Why would you hold or not give this med? Before administering, clarify all ambiguous orders; have second practitioner independently check original order and dose calculations, If respiratory rate is <10/min, assess level of sedation. Physical stimulation may be sufficient to prevent significant hypoventilation. Reports no pain

Evaluation Check after giving

Decrease in severity of pain without a significant alteration in level of consciousness or respiratory status